Sarna L, Lindsey A M, Dean H, Brecht M L, McCorkle R
Nursing Service, VA Medical Center, Sepulveda, CA.
Oncol Nurs Forum. 1993 Apr;20(3):481-9.
The purpose of this descriptive longitudinal study was to describe the relationship of nutritional intake to weight change, symptom distress, and functional status over a six-month period in 28 subjects with progressive lung cancer. The majority of the subjects had non-small cell lung cancer and had lost less than 10% of their body weight at the time of study entry. Body weight, hunger, symptom distress, and functional status were measured every six weeks, beginning two months after diagnosis, for a six-month period. Three-day diet records, which were completed immediately prior to each time point, were averaged to obtain nutrient intake data. Average weight change and nutritional intake showed little variation over time, but the ranges were large. Lower intake of kilocalories was moderately related to functional status at Times 1 and 5 (r = -0.56; r = -0.66, respectively). Kilocalorie intake at a previous time was related to subsequent functional decline at two of the six-week data points (r = -0.71; r = -0.75). Weight change was not directly related to kilocalorie intake. Percentage of weight loss over time was greater in subjects younger than 65 years of age, in those with small cell lung cancer, and in those who received chemotherapy. Symptom distress and symptoms of hunger, nausea, and appetite disturbance showed subtle fluctuations over the six-month period and had inconsistent relationships with food intake over time. Further study is needed to describe nutritional changes that follow a diagnosis of lung cancer and to identify areas for nursing intervention.
这项描述性纵向研究的目的是描述28例进展期肺癌患者在六个月期间营养摄入与体重变化、症状困扰及功能状态之间的关系。大多数受试者患有非小细胞肺癌，在研究开始时体重减轻不到10%。从诊断后两个月开始，每六周测量一次体重、饥饿感、症状困扰及功能状态，为期六个月。每次测量前即刻完成的三日饮食记录经平均后获取营养摄入数据。平均体重变化和营养摄入随时间变化不大，但范围较大。在第1次和第5次测量时，较低的千卡摄入量与功能状态呈中度相关（r分别为-0.56和-0.66）。在六个为期六周的数据点中的两个点上，前一次的千卡摄入量与随后的功能下降相关（r分别为-0.71和-0.75）。体重变化与千卡摄入量无直接关系。65岁以下的受试者以及患有小细胞肺癌且接受化疗的受试者，随时间推移体重减轻的百分比更大。症状困扰以及饥饿、恶心和食欲紊乱等症状在六个月期间有细微波动，且随时间推移与食物摄入量的关系不一致。需要进一步研究以描述肺癌诊断后的营养变化，并确定护理干预的领域。
